Weight-Bearing CT Scans Improve Precision in Flatfoot Surgery Planning

A recent study published in the The Indian Journal of Radiology & Imaging, suggests that surgeons favor weight-bearing CT scans in the assessment and planning of surgeries for flatfoot deformities.

The major cornerstone of the surgical planning for flatfoot deformities have long been weight-bearing radiographs. But, this method pose challenges such as bone superimposition and the lack of reproducibility. So, the introduction of weight-bearing CT scans boast a unique design that addresses these limitations and allows for cross-sectional imaging of the foot in its natural weight-bearing position.

The study was conducted on a total of 19 known cases of flatfoot which showed the efficacy of weight-bearing CT scans in providing a comprehensive assessment of foot deformities. Each foot was evaluated in detail for various angles, including the Meary and calcaneal angles. Also, experts examined the presence or absence of extra-articular talocalcaneal impingement and subfibular impingement. The scans also revealed associated abnormalities such as secondary osteoarthritic changes.

Abnormal Meary and calcaneal angles were observed in almost all cases, with forefoot abduction detected in 7 out of the 19 feet. The hind foot valgus angle exceeded 10° in every patient. The extra-articular talocalcaneal impingement was identified in 13 feet, while the secondary osteoarthritic changes were evident in 14.

The outcomes of this study emphasized the utility of weight-bearing CT scans in evaluating flatfoot and its complications. By offering multiplanar three-dimensional assessments of the foot in its natural weight-bearing state, the weight-bearing CT scans surpasses the limitations of conventional radiographs. The findings highlight the distinct advantage of this approach over conventional methods which lies in its critical capability to capture the dynamics of foot under the natural weight-bearing conditions.

Reference:

Pilania, K., Jankharia, B., & Monoot, P. (2019). Role of the weight-bearing cone-beam CT in evaluation of flatfoot deformity. The Indian Journal of Radiology & Imaging, 29(04), 364–371. https://doi.org/10.4103/ijri.ijri_288_19